Figure 3.

Sequential SPEP, IFE, HLC ratios, and FLC ratios in two patients with IgAκ myeloma. In patient A (a), IFE became negative at a time when abnormal HLC ratio and FLC ratio still indicated presence of residual disease. Both later tests became normal with further follow-up. The kinetics of FLC ratio corresponded with the changes of the HLC ratio during the entire follow-up. In patient B (b), both IFE and HLC ratio became normal at the same time. The HLC ratio became abnormal indicating relapse when IFE was still normal. IFE remained normal for further 5.5 months. Thereafter, laboratory relapse was confirmed by IFE; later clinical relapse was noted.